GOLDEN, Colo., June 28-A healthcare ratings organization has updated its information on nearly 1,500 hospitals in 17 states that treat women for cardiovascular disease.

HealthGrades, a private healthcare quality assessment service, said that the quality of cardiovascular care for women lags significantly behind such care for men. The ratings of women's health care can be viewed at www.healthgrades.com.

Overall, the HealthGrades study offered good news. The mortality rate for women treated for cardiovascular disease improved by about 11% from 2001 to 2003 at the hospitals included in the study.

However, the study points out a dramatic difference in mortality rates between the best-performing and worst-performing hospitals. Women at the best hospitals had a 39% lower mortality rate for cardiovascular care than women at the poorer hospitals. The widest improvement gap was in heart failure, where the best hospitals improved an average of 23.7% compared with about 4.3% improvement at the worst hospitals.

The lower scores at poorer-performing hospitals may be tied to a lack of awareness among women and their doctors about the impact of cardiovascular disease on women, the study authors said.

"Heart disease and stroke are the first and third leading cause of death among women," said Samantha Collier, M.D., a study author and vice president of medical affairs at HealthGrades. "And yet, only a small percentage of women believe that cardiovascular disease is their biggest threat, and only one in five doctors know that cardiovascular disease kills more women than men each year."

The study noted that women tend to receive suboptimal preventive care and treatment for cardiovascular disease, and that physicians tend to designate women as lower risk than men who have identical risk profiles. Even when the disease is recognized in women, gender influences how physicians manage chest pain and decisions about who receives cardiac catheterization, the study said.

"Consequently, we encourage women to ask and know about their cardiovascular risk and for providers to assess and understand how they might improve the management of cardiovascular disease in women," the study authors said. "We believe there is also a significant opportunity for healthcare providers to take the lead as the primary source of information for the women in their community as healthcare consumerism continues to increase."

The study authors urged women and their doctors to arm themselves with this information and seek out hospitals that have excellent women's health programs.